As An Eating Disorder Therapist, I’m Concerned About Netflix’s ‘To The Bone’

The trailer of Netflix’s upcoming movie, ‘To The Bone,’ opens with a plate of food and a young, frail, girl tallying up the calorie counts of each item. Her friend laughs and says, “it’s like you have calorie Asperger’s.”

The movie, which was written and directed by Marti Noxon and stars Lilly Collins and Keanu Reeves depicts a young girl’s battle with anorexia. It has already been met with a lot of controversy, especially within the eating disorder recovery and treatment community.

I think that the creation of this film was well-intentioned. The director and lead actress both shared that they have personally struggled with eating disorders in the past, and that their aim was to raise awareness and to diminish shame and secrecy.

Raising awareness of eating disorders and diminishing shame and stigma surrounding seeking help is crucial.

However, as an eating disorder therapist in private practice in Rockville, Maryland, I have some major concerns about the way that anorexia is being depicted both in the trailer and in the press surrounding the movie.

The Problems With The Press Coverage

Lilly Collins, who says that she recovered from anorexia herself, has appeared in press interviews for the movie where she discusses how she lost weight for the role “in the most healthy way possible,” with the help of a nutritionist.

It was difficult for me to even type that sentence. Saying that someone with a history of anorexia is able to “lose weight in a healthy way,” is akin to sharing that an individual with a history of alcoholism is able to “drink in a healthy way.” It’s just not possible and frankly it’s an incredibly irresponsible message to share, as it could be highly triggering to someone in recovery from an eating disorder.

Let me make one thing clear, there is no such thing as purposeful “healthy weight loss” for someone with a history of anorexia. Even if an individual’s intention is to do it “in a healthy way” (whatever the heck that even means?!) they have underlying genetic and temperamental factors for a life-threatening mental illness, which can be activated by energy deficit and weight loss (regardless of what the intention behind this is).

Concerns About The Trailer

The problem with depicting a story that details someone’s struggle with an eating disorder is that it can quickly become a “how to” manual for those who are already struggling or have the underlying genetic predisposition towards an eating disorder.

As an eating disorder specialist, I can tell you that eating disorders are often “competitive illnesses.” Individuals in recovery who view this film could easily use it to continue to fuel their eating disorder.

Further, the trailer reinforces stereotypes and myths about people who have anorexia. It’s depiction of someone with anorexia as an emaciated, Caucasian, young female, who is starving herself to “feel in control,” is not representative of the variety of people impacted who struggle with this disease.

First off, while the desire to feel “in control” might be one aspect of an individual’s struggle with anorexia, it’s important to highlight that eating disorders are caused by a combination of genetic, temperamental, and psychological factors, which are then triggered by environmental stressors. Depicting anorexia as a desire to be “in control” or to “look like a model,” perpetuates the myth that people are simply “making a choice,” rather than struggling with a serious mental illness.

Additionally, eating disorders do not discriminate based upon age, gender, or race. In my practice, I have worked with teens and adults, men, women, transgender individuals, as well as people of diverse races and ethnicities.

It is also often hard for those with anorexia to recognize that they are struggling with the disease, as “the eating disorder self” will often tell them that they are not. There already is this pervasive cultural narrative that anorexia mainly impacts young, white, Caucasian, females. Therefore, I’m worried that someone who is struggling with doesn’t meet these narrow criteria might not seek help, as they believe that they couldn’t possibly have an eating disorder.

Also, eating disorders (including anorexia) can impact people across the weight spectrum. It’s important to note that you do not have to appear emaciated, like the lead actress in the film, to be struggling with anorexia. This dangerous myth can cause people to avoid seeking life-saving treatment, as they might believe that they are “not sick enough” to get help.

You cannot tell who is struggling with an eating disorder by looking at them. Eating disorders are one of the few mental illnesses, where we judge someone’s “level of suffering” based on their physical appearance. This is not ok. Someone can be seriously struggling with anorexia-at any size. No matter what your weight is, if you are struggling with an eating disorder, you deserve to seek treatment and help.

The Bottom Line

If you or someone you know thinks that they might be struggling with an eating disorder, it’s so important to reach out for help from a professional.

Seeking help when you are struggling is a sign of true strength, not weakness. No one should have to struggle with an eating disorder alone.

With access to treatment and support, individuals with anorexia can recover and go on to lead meaningful and purpose-driven lives. Full recovery is possible!